A stab in the heart
The consequences of a heart attack will be treated with stem cells
The new technology will avoid surgery
Maria Nedyuk, Izvestia
Russian doctors have learned how to treat complex cardiac pathologies, including the consequences of heart attacks, with the help of stem cells. The drug created on their basis is administered to the patient using a dropper. Injections directly into the heart muscle are also possible. The technique makes it possible to reduce the lesion, reduce pain, and make the vessels more elastic. This will increase the duration and quality of life of the patient. In some cases, a stem cell-based drug administered on time will help to avoid surgery.
Matters of the heart
Scientists of the A. A. Vishnevsky Central Military Clinical Hospital of the Russian Ministry of Defense, together with specialists from Tula State University, are implementing an experimental method for the treatment of severe post-infarction conditions using cellular technologies. As Denis Ivanov, professor of the Department of General Pathology at TulSU, explained to Izvestia, the essence of the technique is to partially replenish the stock of that part of the muscle cells of the heart – cardiomyocytes that die during a heart attack.
– There are several tasks that we have to solve. First, germinate the vessels in the damaged tissues so that they can feed. Secondly, to remove the inflammatory process. Thirdly, to increase the efficiency of the remaining cells and stimulate the emergence of new ones, – said Denis Ivanov. – The earlier the procedure developed by us is carried out after a heart attack or severe damage to the heart, the more likely it is that the cells that are in a borderline state will survive and we will reduce the lesion – ischemia.
The essence of the technique is as follows. The cellular drug is injected with a dropper to a patient who has undergone a complex heart operation. Also, the drug can be injected directly into the heart muscle in the form of an injection during an open operation. Once in the patient's body, stem cells accumulate in the area of damage, for example, in the area of the scar left after cardiac surgery. Then they differentiate into cardiomyocytes. As a result, the heart begins to contract better, the vessels become more elastic, and the patient's ischemic pain syndrome significantly decreases, exercise tolerance increases, and overall both the duration and quality of life increase.
– Plus, the patient gets the effects that are always present when performing procedures related to cellular technologies. This is an effect on the neuroendocrine system: mood improves, appetite increases, performance increases," Denis Ivanov noted.
Strangers against their own
Multipotent mesenchymal stromal cells (MMSCs) are used to manufacture the drug. They can be taken from both the patient and the donor. However, as Denis Ivanov explained, now doctors prefer to work with donor cells.
– If a person is ill for a long time or has a hereditary disease, then a program is written in every cell of his body that, for example, in middle age he will have high cholesterol, and in adulthood the vessels will die. Of course, we can take his material, work with him for a long time in the laboratory, grow him, increase his mass. But the efficiency will be extremely low," the specialist noted.
In the clinic, scientists work mainly with donor material taken from stem cell banks. In such repositories, there is also material obtained from umbilical cord blood, which comes there from maternity hospitals. The advantages of applying to biobanks is that the donor material has already been tested for the absence of bacteria, viruses and fungi and it can be used almost immediately.
Alexander Lischuk, head of the Cardiac Surgery Center of the A.A. Vishnevsky Central Military Clinical Hospital, told Izvestia that the method of introducing MMSC to patients who have suffered a heart attack has already been successfully applied.
– This is an effective method, it makes the postoperative scar more elastic, helps the patient recover faster. And in some cases, the early introduction of these cells can even save the patient from surgery, – said Alexander Lischuk.
The research in which stem cells are used to try to achieve full-fledged tissue recovery after damage is very promising, Director of the SUSU Higher School of Biomedical Sciences (a university participating in the 5-100 project), Professor Vadim Tseilikman is sure. However, there are problems with the mass introduction of cellular techniques.
– As far as I know, the use of stem cells requires going through a very impressive bureaucratic corridor and agreeing on a protocol in many instances. This is due to the risk of getting the most unpredictable side effects from the use of stem cells. Therefore, unfortunately, there is no confidence in the rapid introduction of this innovation into practical medicine," the expert noted.
Now the technique of "cell injection" in the heart is performed to patients as part of a large-scale research work on indications. However, in the long term, when it does enter mass clinical practice, the technique is planned to be used not only to treat the consequences of heart attacks, but also to prevent them.
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